...from our group insurance company.
It seems they’d received a request for an insurance card from an employee who had never carried the health insurance. They wondered if we (the two people in HR) knew what was going on. We didn’t, so we asked the person to swing by the HR office.
She told us, “But I’ve always had the insurance—from day one! The money’s been coming out of my paycheck.”
(“Day one” was May 1, 2005. That’s when we had our enrollment in the new plan.)
We showed her the enrollment form. At the top she was supposed to select the coverage desired, and nothing was selected. “Oh,” she said, “I must have missed that little box. But look, down at the bottom. There’s a place where I have to waive coverage if I don’t want it and sign the form. I checked that I was waiving DEPENDENTS coverage, but not EMPLOYEE.”
She was right. I pointed out that the money deducted from each of her checks was only a few dollars, and THAT was to cover the life insurance she’d opted for, plus the Long Term Disability coverage. Health insurance was MUCH more expensive.
With a blank look she said, “Oh. I never paid any attention.”
Then I pointed out that on May 1 of THIS YEAR we had announced a significant rate increase. Hadn’t she noticed that her deduction stayed the same?
So why did she now decide she wanted an insurance card?
“I went to the doctor’s last week and they wanted a copy of my card, but I didn’t have one.”
I huddled (on the phone) with our carrier, and later presented her with two options:
1. Fill out a new enrollment form, date it April, 2005, indicate that you DO want coverage, pay us the last 15 months worth of employee contributions (well over $1,000), and you’ll have full, regular coverage. (Remember, until now she’s had NO claims of any kind.)
2. Fill out an enrollment form dated April, 2006 (our last annual “late enrollment” window), indicate that you now want coverage, pay us the last 3 1/2 months of employee contributions (over $300), and you’ll have coverage. BUT as a late enrollee, you’ll have a “pre-existing condition limitation.” The plan will exclude any condition for which you’ve received treatment in the last 18 months.
She smiled at this no-brainer choice. “I haven’t had any claims for over 18 months, so I’m sure I have no ‘pre-ex’ conditions. I’ll take option 2.”
“Good choice. But from now on, pay attention to the deductions from your pay, and ask about any that don’t seem right, OK?”
She nodded. We’ll see. (No, she is NOT blonde.)